Columnist Joanna Buoniconti: Where have all the home care nurses gone?

Published: 8/2/2021 1:58:52 PM

Around 3:30 p.m., March 15, 2020, my mom called my local pulmonologist after watching in disbelief the number of COVID-19 cases rise by the hour.

I was working on an article in my office for my college’s magazine about how the chancellor had announced hours after spring break had begun that classes would be resuming online for at least two weeks after the break. But that didn’t stop me from overhearing snippets of my mom’s concerned voice, at a decibel that was bordering on shrill, asking my doctor whether it was safe for her to go back to work and allowing a staff of three nurses in our home to take care of me.

At the time, my mom had been working as a physical therapist in a nursing home. Each day when she came home, she immediately jumped in the shower before coming near me, to avoid exposing me to a behemoth amount of bacteria on a good day, let alone when a deadly novel virus was thrown into the mix.

My pulmonologist advised her to take a two-week leave from work and to keep one nurse on the staff while the virus ran its course. After talking it over, we decided which nurse would pose the least amount of risk, but upon talking to the nursing agency and learning that she had been out to eat in a crowded restaurant the night before, we were forced to alter our decision.

Together, my mom and I made the decision to forego having nurses for the time being. We had no clue that the virus would still be dictating our lives a year and a half later. Furthermore, we had no clue that it would be borderline impossible to find nurses in the aftermath. Just like everyone else, we thought it would only be for a couple of weeks.

At the beginning of March 2021, a few weeks after my mom and I had received both of our vaccines, we agreed that it was time to begin bringing nurses back. Because while I do love my mom more than anything, it has been a lot to be stuck in the house with her day in and day out for this past year, especially given the fact that I require 24-hour care. And to put it bluntly, at that point, we were both desperately craving a break from each other.

Unfortunately, none of the nurses that I had before COVID were available. My favorite one, who had become like a mother and best friend combined, retired due to health problems. Another one began working at the hospital and quit home care altogether, and the other one had gotten new clients. They were the best group of nurses that I had had in a long time, and we were now facing the prospect of essentially starting from scratch. That was a hard pill to swallow, in and of itself, never mind the fact that the pickings for home care nurses are incredibly slim.

It wasn’t until the middle of April when my mom had taken to calling them on a daily basis that one of the home care agencies actually sent out a nurse for us to interview. And it was, ironically, a nurse we had fired three years ago because she wasn’t an appropriate fit. Now, she was the only prospect for my mom to get some much-needed respite for a few hours a week, so we had little choice but to hire her.

The other nursing agency, which had been more successful at procuring nurses for me in the past, has flat out told my mom and me on numerous occasions that they have no nurses for me — no matter how many times my mom and I have both pleaded and cried to them.

The blatant lack of home care nurses is not only a problem in western Massachusetts, but extends across the entire country as well. One of my closest friends who shares the same disease as me, Dominick Trevethan, 22, lives 3,000 miles away in Solvang, California. He and I have had this conversation numerous times throughout the past year over our combined rightful exasperation at the situation.

Although our situations are similar in a lot of ways, they are very different in others. Because he lives with his elderly grandparents, who handle the majority of his care, he was not allowed the luxury of being able to forego his two night nurses during this time. The arrangement they had was that the two nurses would alternate nights to help Trevethan with his respiratory routines and to reposition him throughout the night, with the intention of allowing his grandparents to get some sleep. And that schedule was working until one of the nurses quit without giving notice a few months into the pandemic, which effectively left them in even more of a lurch.

And almost a year later, Trevethan’s home care agency has yet to find a sufficient replacement. The most recent nurse they sent was so incompetent that she was creating more issues for both him and his grandparents instead of helping — so he had to fire her.

“I just feel bad for my grandma because she’s the one that ends up having to sleep on the couch when there’s no nurse. And then the agency tells us they’ll have a replacement within the next couple weeks and I’m like yeah right!” Trevethan says.

The lack of adequate help is an unfortunate reality that so many of us have to face, and it is an issue that is not new to Trevethan at all, considering that he had to move home from college due to not being able to procure nurses. Since the overall lack of home care nurses is tied to burnout, lack of benefits and low pay, it is no wonder why Trevethan and others are having difficulty recruiting caregivers.

Massachusetts has very recently recognized this need and have made efforts to increase the pay of home care nurses. But there is still a lot more that needs to be done in order to ensure that disabled individuals get the care that they deserve.

In the meantime, I would love to hear from government officials on what people like me and Trevethan are supposed to do.

Gazette columnist Joanna Buoniconti is a recent graduate from UMass Amherst. She can be reached at

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